Vaccination Concerns for Patients with Chronic Dermatitis

Vaccination inquiries?

Hello Dr.
Hong, I visited the dermatologist last week for a follow-up appointment.
The doctor said I have chronic eczema and advised me to continue applying the medication.
It seems to be improving as I no longer see any flakes.
Last time, there was slight redness, but after applying the medication for about a day or two, it got better, although it has darkened a bit.
During the follow-up, I also asked if I could get vaccinated, and he said it was fine, so I should go ahead and make an appointment.

I'm not sure if this is psoriasis, but can I receive the AstraZeneca or Moderna vaccines? Is there a difference in safety for me? I've heard that Moderna may have stronger allergic reactions, so I wanted to get your advice on this.
Additionally, the doctor prescribed a larger tube of ointment this time and said that since there are no more flakes, I should apply it until then.
He also mentioned that I should maintain a regular routine and manage stress to prevent recurrence.
However, since it appears dark, does that mean I am recovered and don't need to apply it continuously? I looked up in the morning and it seems to be betamethasone; I'm concerned if using too much of this steroid could thin my skin.
Lastly, I wanted to ask about the discussions I've seen regarding the AstraZeneca vaccine being manufactured in Thailand.
Is that considered the same as the one we received from Japan, or could there be differences in quality? Thank you for your response.
This is the current condition of my left elbow and the back of my left foot; the right hand is less noticeable, and there are no issues with the right foot.

Lemon, 20~29 year old female. Ask Date: 2021/07/17

Dr. Hong Yuanbin reply Internal Medicine

Hello, based on your provided skin condition, whether it is psoriasis or another diagnosis, it will not affect the administration of vaccines.
The choice of vaccine type should also not be impacted, and you can receive the vaccine.
The quality of the AZ vaccine is certified by the original manufacturer, and the quality should be reliable.
Thank you for your inquiry.

Reply Date: 2021/07/17

More Info

When it comes to vaccination concerns for patients with chronic dermatitis, such as eczema or atopic dermatitis, it is essential to understand both the condition itself and the implications of vaccination. Chronic dermatitis can be a source of discomfort and may lead to secondary infections if the skin barrier is compromised. However, the presence of chronic dermatitis does not typically contraindicate vaccination.

In your case, since your dermatologist has indicated that your condition is improving and has given you the green light to proceed with vaccination, it is generally safe to do so. Vaccines like AstraZeneca (AZ) and Moderna are both effective and have been shown to be safe for individuals with skin conditions, including chronic dermatitis. The primary concern with any vaccine is the potential for allergic reactions, which can occur in any individual, regardless of their skin condition.

Regarding the concern about the Moderna vaccine and its association with stronger allergic reactions, it is important to note that while some individuals may experience allergic reactions to mRNA vaccines, these instances are relatively rare. If you have a history of severe allergies, particularly to components of the vaccine, it is crucial to discuss this with your healthcare provider before vaccination. They can provide guidance based on your medical history and any previous allergic reactions you may have experienced.

As for the use of topical corticosteroids like betamethasone, it is true that prolonged use can lead to skin thinning (atrophy). If your dermatologist has advised you to continue using the medication until your skin condition is fully resolved, it is likely that they have assessed the benefits versus the risks. It is essential to follow their instructions and to communicate any concerns you have about the appearance of your skin or side effects you may be experiencing. If your skin appears darker or you notice any adverse effects, it is advisable to bring this up during your follow-up appointments.

Regarding the different manufacturers of vaccines, such as those produced in Thailand versus Japan, the quality and efficacy of vaccines are generally consistent across different production sites, as they must adhere to strict regulatory standards set by health authorities. The World Health Organization (WHO) and other regulatory bodies ensure that vaccines meet safety and efficacy requirements, regardless of where they are manufactured. Therefore, while there may be slight variations in formulation or packaging, the overall quality should not differ significantly.

In summary, it is generally safe for patients with chronic dermatitis to receive vaccinations, including AZ and Moderna, especially when cleared by a healthcare professional. It is crucial to maintain open communication with your dermatologist regarding your skin condition and any medications you are using. If you have any specific concerns about the vaccines or your skin treatment, do not hesitate to discuss them with your healthcare provider. They can provide personalized advice based on your health status and history.

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